What causes dry skin?
The outermost layer of skin called the stratum corneum does not have enough moisture, resulting in cracks in the skin surface. This abnormality disrupts the integrity of the barrier function of skin. Keratinocytes are the cells that makeup skin. They lose their water-holding capacity and are not able to properly grow and reproduce. There are inherited forms of dry skin due to mutations in various genes. Dry skin may also be acquired by thyroid deficiency, nutrient deficiency, infection and possible drug side effects.
Risk Factors:
• Low humidity, cool climates, windy conditions, excessive air conditioning, direct heat from fan or heaters
• Contact with soap, laundry detergents or solvents, excessive bathing
• Frictional irritation from rough clothing or abrasives
• Family history
What to expect:
• Dull surface with a rough, scaly quality, flaking, irritation, redness and itchiness
• Decreased elasticity, cracking, inflammation
• Complications can occur including eczema, increased risk for bacteria, fungal or viral infections and contact allergies to nickel or other products due to defective barrier
Treatment options:
• Moisturizer/emollients with creams, oils or ointments applied frequently and consistently
• Best emollients include urea or propylene glycol
• Apply right after showering for better moisture absorption
• If areas are itchy or there is a coexisting dermatitis, topical steroids and calcineurin inhibitors such as Protopic can reduce unwanted symptoms
Why treat?
• Alleviate itch
• Improve the skin barrier function, integrity and flexibility
• Prevent entry of bacteria, viruses or fungus
• Reduce transepidermal water loss
How to prevent dry skin:
• Eliminate aggravating factors by reducing the frequency of bathing, using a humidifier, shorten showers/baths
• Drink plenty of water
• Use lukewarm water instead of hot water
• Avoid using hand sanitizer frequently
• Use emollients often
- Carly Chandler, PA-C
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